School Information
Instructor’s First Name: Russ Yost
Instructor’s Last Name: Yost
Instructor’s Phone Number: 316-448-2072
Instructor’s Email: info@yostdrivingschool.com
School Name: Yost Driving School
School Address Line 1: 1735 E 2nd St
School Address Line 2: Ste A
School City: Wichita
School State: KS
School Zip: 67214
USD No: N/A
Student Information
Legal First Name: Harika
Middle Name:
Legal Last Name: Bepeta
Suffix : Please Select. . .
Phone Number : 6105457321
Address Line 1: 1728 Fairmount St, Apt 209
Address Line 2:
City : Wichita
State: KS
Zip : 67208
Sex: Male_____ Female__X__
Date of Birth: 12/17/1997
Eye Color: BLK
Height: __5___ft __2___In
Weight in lbs: 152
License Questions
Are you a resident of Kansas? Yes__X__ No_____
Have you attended driver education in the past 12 months? Yes_____ No__X__
If yes, did you complete and pass driver education? Yes_____ No__X__
Do you have a Kansas Credential (identification, permit, driver's license)? Yes__X__ No_____
If yes, enter the Kansas Credential Number: K04-46-0292
Parent and student can sign at the same time or seperately. If the other party isnt present just fill out your part and check "I agree" and "Submit All"
After submitting you can close this window. You can click "Start over" to remove your signatures